Prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous populations in Brazil: a systematic review and meta-analysis

Abstract The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.

Subjective oral health measures in caregivers of patients with autism spectrum disorder and down syndrome: a preliminary study

This study aimed to address the subjective oral health measures of caregivers of individuals with autism spectrum disorder (ASD) and Down syndrome. This cross-sectional study included 15 caregivers of individuals with ASD (n = 7) and Down syndrome (n = 8). Sociodemographic data, sense of coherence (SOC) (SOC-13 scale), social support (Social Support Scale [MOS-SSS]), oral health-related quality of life (OHRQoL) (OHIP-14), and self-rated oral health assessed on a 5-point Likert scale were collected. A descriptive analysis was performed in addition to correlation analyses (Spearman correlation coefficient). Most primary caregivers were parents of the individual (86.6%). The age of the caregivers ranged between 40 and 59 years (60%). Most caregivers have had 9 to 11 years of education (53.3%). Monthly family income was less than USD 186,28 for ASD caregivers (57.2%) and between USD 327,56 and USD 931,40 for Down syndrome caregivers (50%). Of the caregivers, 33.3% reported good oral health and 33.3% reported neither good nor bad. The average SOC score, social support and OHRQoL was 48.9, 69.3 and 10.9, respectively. The higher the family income, the better the OHRQoL (rs = -0.62, p = 0.014). SOC was correlated with the score of the emotional support domain (rs = 0.54, p = 0.039). It was concluded that caregivers had a strong SOC and high perceived support. Moreover, caregivers did not report a high impact on OHRQoL A better understanding of the caregivers' protective and coping factors in caring for individuals with disabilities may better promote their quality of life.

Effect of Chewing Gum Containing CPP-ACP on Salivary Flow and Buffer Capacity: An in vivo Study

Objective: To evaluate salivary flow and buffer capacity by means of mechanical and chemical-mechanical stimuli, through the use of chewing gums. Material and Methods: The study was a cross-sectional study with 12 volunteers, divided into three groups, in three phases: Group A: paraffin gum; Group B: Chewing gum without sucrose, flavored (Trident®); Group C: Flavored chewing gum, without sucrose and amorphous calcium casein-phosphate phosphopeptide (Trident Total®). The stimulated total saliva was collected after 5 minutes of mastication of one of the products and the volume was expressed in mL / min. The same sample was submitted to pH measurement with the use of a digital potentiometer, where the results were classified in normal buffer capacity (final pH between 5.0 and 7.0) or low (final pH <4.0). The results were evaluated regarding the normality of the sample distribution (Shapiro-Wilk test), Analysis of Variance (ANOVA) and Tukey's test. Results: Chewing gums increased the salivary flow of the volunteers, when compared to the control group (paraffin) (1.53 mL / min), differing statistically from the group, although there was no difference between Trident® (2.09 mL / Min) and Trident Total® (2.06mL / min). Regarding the buffer capacity, the values obtained were 6.94 (paraffin), 6.99 (Trident®) and 6.93 (Trident Total®), with no difference between groups (p = 0.713). Conclusion: It was concluded that chewing gums, with and without CPP-ACP, increased the salivary flow in relation to the control group. In relation to buffer capacity the values obtained for chewing gums with and without CPP-ACP, are shown to be within the normal range.

Alterações em mucosa bucal de pacientes portadores de Diabetes Mellitus / Oral mucosa alterations in Diabetes Mellitus patients

O objetivo deste estudo é verificar a presença de alterações, patológicas ou não, na mucosa bucal de pacientes portadores de diabetes mellitus, através de exame clínico intrabucal. Trata-se de um estudo epidemiológico de corte transversal em pacientes portadores de diabetes mellitus, atendidos no Ambulatório Araújo Lima, avaliados através de exame semiológico de rotina de tecidos moles da cavidade bucal. Após assinatura do TCLE os pacientes responderam um questionário semiestruturado com perguntas referentes ao desenvolvimento e evolução da diabetes. Após, os pacientes foram submetidos a exame intrabucal onde as observações foram anotadas em fichas específicas pertencentes ao prontuário padrão da Faculdade de Odontologia. Os dados coletados foram analisados por meio de estatística descritiva, e as variáveis do estudo, submetidas ao teste do Qui-quadrado para verificação de correlação (p≤0,005). Os pacientes examinados foram, em sua maioria, do gênero feminino (51,9%) e portadores do tipo 2 da doença (88,5%) e os achados da pesquisa consistiram em alterações patológicas e do desenvolvimento, e esta última em maior prevalência como Grânulos de Fordyce (63,5%), Pigmentação Melânica (36,5%) e Língua Fissurada (32,7%). Diabetes mellitus pode influenciar de maneira significativa os tecidos bucais, induzindo o surgimento de lesões patológicas, porém, no presente estudo, os pacientes apresentaram alta prevalência de alterações com aspecto clínico dentro do padrão de normalidade distribuídos através da mucosa jugal, língua e gengiva

The aim of this study is to verify the presence of alterations, pathological or not, in the oral mucosa in patients with diabetes mellitus through intra-oral clinical examination. This was an epidemiological cross-sectional study in patients with diabetes mellitus treated at the Araujo Lima Service, evaluated through examination of tissues routine moles of the oral cavity. After signing the informed consent, the patients completed a semistructured questionnaire on the development and progression of diabetes. Afterwards, the patients underwent intra-oral examination where the observations were noted in specific records belonging to Dentistry. Data were analyzed using descriptive statistics and the study variables were submitted to the chi-square test for correlation check (p≤0,005). The examined patients were mostly female (51.9%) with type 2 diabetes (88.5%) and research findings consisted of pathological changes and development, and the latter in higher prevalence as granules Fordyce (63.5%), melanin pigmentation (36.5%) and tongue Fissured (32.7%). Diabetes mellitus can significantly influence the oral tissues, inducing the emergence of pathological lesions; however, in this study, patients had a high prevalence of alterations with clinical aspect within the normal range distributed through the buccal mucosa, tongue and gums

Bacterial diversity in the saliva of patients with different oral hygiene indexes

The objective of the present study was to evaluate the bacterial diversity in the saliva of patients with different oral hygiene indexes using of two 16S rRNA gene libraries. Each library was composed of samples from patients with different averages of the differentiated Silness-Löe biofilm index: the first library (A) with an index between 1.0 and 3.0 (considered a high index) and the second library (B) between 0 and 0.5 (considered a low index). Saliva DNA was extracted and the 16S rRNA gene was amplified and cloned. The obtained sequences were compared with those stored at NCBI and RDP GenBank. The saliva of patients with high index presented five known genera - Streptococcus, Granulicatella, Gemella, Veillonella and Peptostreptococcus - and 33.3% of nonculturable bacteria grouped into 23 operational taxonomic units (OTUs). The saliva of patients with low index differed significantly from the first library (p=0.000) and was composed of 42 OTUs distributed into 11 known genera - Streptococcus, Granulicatella, Gemella, Veillonella, Oribacterium, Haemophilus, Escherichia, Neisseria, Prevotella, Capnocytophaga, Actinomyces - including 24.87% of nonculturable bacteria. It was possible to conclude that there is greater bacterial diversity in the saliva of patients with low dental plaque in relation to patients with high dental plaque.

O objetivo do presente estudo foi avaliar a diversidade bacteriana da saliva de pacientes com diferentes índices de higiene bucal através da construção de duas bibliotecas do gene 16S rRNA. Cada biblioteca foi composta por amostras de saliva de pacientes com índice de biofilme dental de Silness-Löe diferenciado, sendo a primeira (A) com índice de 1,0 a 3,0 (denominada de alto índice) e a segunda (B), entre 0 a 0,5 (denominada de baixo índice). O DNA da saliva foi extraído e o gene 16S rRNA foi amplificado, clonado e sequenciado. As sequências obtidas foram comparadas com aquelas armazenadas no GenBank do NCBI e RDP. A saliva de pacientes com alto índice de biofilme dental apresentou cinco gêneros conhecidos: Streptococcus, Granulicatella, Gemella, Veillonella e Peptostreptococcus e 33,3% de bactérias não-cultivadas, agrupados em 23 unidades taxonômicas operacionais (UTOs). A saliva de pacientes com baixo índice de biofilme dental, foi diferente significativamente da primeira (p=0,000) e foi composta de 42 UTOs, distribuídas em 11 gêneros conhecidos: Streptococcus, Granulicatella, Gemella, Veillonella, Oribacterium, Haemophilus, Escherichia, Neisseria, Prevotella, Capnocytophaga, Actinomyces, além de 24,87% de bactérias não-cultivadas. Pode-se concluir que existe maior diversidade bacteriana na saliva de pacientes com baixo índice de biofilme dental em relação a pacientes com alto índice de biofilme dental.

Evaluation of commercial fluoride solutions on bovine enamel demineralization, using pH-cycling model / Avaliação de soluções fluoretadas comerciais na redução da perda mineral em esmalte bovino, utilizando modelo de ciclagem de pH

Purpose: The aim of this in vitro study was to evaluate the fluoride concentration in mouthrinses and their capacity to intervene with the caries process. Methods: The analysis of the fluoride concentration in the solutions was carried with ion specific electrode connected to an ion analyzer. Bovine incisors enamel blocks with previously known superficial microhardness were submitted to a pH cycling model and treated with fluoridated solutions, and later reanalyzed for microhardness and fluoride incorporation. Results: The fluoride concentration (ppm) found in the solutions SANiFill- Sanikids®, Colgate Plax Fresh Mint®, Oral B®, Sorriso Fresh® and Cepacol® (not fluoridated) were, respectively: 242.91±21.89; 248.42±3.55; 248.29±11.31; 257.61±17.57 and 35.37±10.64. The lowest loss of superficial microhardness was observed with the use Sorriso Fresh® (29.66%± 8.84), followed by Plax Fresh mint® (32.99%±14.09) and Oral B® (43.00%±18.34). Conclusion: The data suggest that fluoride solutions, in proper concentrations, are capable of intervening on the phenomena of demineralization and remineralization, promoting fluoride incorporation and, consequently, decreasing the loss of microhardness on dental enamel.

Objetivo: O objetivo deste estudo in vitro foi analisar a concentração de flúor em diferentes soluções fluoretadas para bochechos e sua capacidade de interferir no processo de cárie. Metodologia: A análise da concentração de flúor nas soluções para bochecho foi realizada com eletrodo específico para íon flúor acoplado a um analisador de íons Orion. Blocos de esmalte de dentes incisivos bovinos com a microdureza superficial conhecida foram submetidos à ciclagem de pH e uso de soluções fluoretadas, sendo, posteriormente, avaliados por uma nova análise de microdureza e também pela incorporação de flúor. Resultados: As concentrações de flúor (ppm) encontradas nas soluções SANiFill®, Colgate® Plax®, Oral B®, Sorriso® e Cepacol® (não fluoretada) foram, respectivamente: 245,94; 247,61; 251,50; 258,01 e 38,44. A menor perda de porcentagem de dureza superficial foi observada com o uso da solução fluoretada Sorriso® (29,7%±14,4), seguida por Colgate® Plax® (33%±14,1) e Oral B® (43%±18,3). Todas as soluções fluoretadas analisadas mostraram capacidade de incorporar flúor no esmalte dental. Conclusão: Os dados sugerem que as soluções fluoretadas foram capazes de interferir nos fenômenos de desmineralização e remineralização, promover incorporação de flúor e, conseqüentemente, diminuir a perda de dureza no esmalte dental.

Antimicrobial activity of Arctium lappa constituents against microorganisms commonly found in endodontic infections

A atividade antimicrobiana de extratos brutos de folhas de Arctium lappa, bem como de suas fases, foi avaliada in vitro. Os microrganismos Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis e Candida albicans, comuns na cavidade bucal, especificamente em infecções endodônticas, foram utilizados. O método de difusão em Agar permitiu a detecção da fase hexânica como inibitória do crescimento microbiano. Ensaios de bioautografia identificaram substâncias antimicrobianas presentes no extrato. Os resultados demonstraram a presença, na fase hexânica bruta e em suas sub-frações, de constituintes que têm Rf (fatores de retenção) em três zonas distintas, sugerindo a presença de ativos com estruturas químicas de diferentes polaridades, que exibiram especificidade contra os microrganismos alvos. Conclui-se que os constituintes de Arctium lappa apresentam um grande potencial de inibição microbiana contra os microrganismos endodônticos estudados.